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ECT rekindles pharmacological response in schizophrenia

Published online by Cambridge University Press:  16 April 2020

H. Hustig  and
R. Onilov
H. Hustig
Affiliation:
Central Northern Adelaide Health ServiceRoyal Adelaide Hospital, Adelaide, Australia
R. Onilov*
Affiliation:
Central Northern Adelaide Health ServiceRoyal Adelaide Hospital, Adelaide, Australia
*
*Corresponding author. 5/21 Giles St, Toorak Gardens, SA 5065, Australia. Tel.: +61 8 83311324, +61 439578617 (mob). E-mail address:[email protected] (R. Onilov).
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Abstract

Objective

The aim of our naturalistic-observational study was to determine the efficacy and utility of electroconvulsive therapy (ECT) in clinical population of individuals with schizophrenia where pharmacological response was suboptimal.

Methods

The cohort comprised 27 patients suffering from schizophrenia with refractoriness to antipsychotic agents and with severe, disabling symptoms. They only interventional assessing tool was clinical global impression (CGI-S) performed at the baseline and at the end of the treatment.

Results

The administration of ECT resulted in overall clinical improvement reflected in CGI scales and descriptions in clinical notes. On 12 months follow-up period, 10 patients (37.1%) maintained improvement and were able to continue with pharmacological therapy only, suggesting its rekindling effect, especially with Clozapine. Conversely, 17 patients (62.9%) deteriorated and required an additional course of ECT to maintain improvement. In some cases, maintenance ECT treatment was required. The group who engaged in self-harming behaviour at baseline demonstrated they were more likely to relapse into psychosis at the end of the first course of ECT, their self-harming behaviour abated, especially when maintenance ECT was undertaken.

Conclusions

Although limited by lack of control group, small sample size, heterogeneous symptom profiles and various concurrent neuroleptic agents, the ECT proved as valuable and safe augmentative procedure when unsatisfactory response to pharmacological interventions had been demonstrated prior to interventions. This effect was evident despite the chronicity of the illness.

Keywords

ECTSchizophreniaPharmacological responsiveness
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 8 , December 2009 , pp. 521 - 525
Copyright
Copyright © Elsevier Masson SAS 2009

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Footnotes

1

Rehabilitation Services, Glenside Campus, CNAHS, Adelaide, Australia.

2

Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.

References

Arato, MBagdy, GNeuroendocrine study of the mechanisms of action of electroconvulsive therapy. Neuropsychobiology 1982;8:162–168CrossRefGoogle Scholar
Brenner, HDDencker, SJGoldstein, MJet al.Defining treatment refractoriness in schizophrenia”. Schizophr Bull 1990;16:551–561CrossRefGoogle Scholar
Green, AZalma, ABerman, Iet al.Clozapine following ECT: two-step treatment. J Clin Psychiatry 1994;55:388–390Google ScholarPubMed
Green, ARDeakin, JWFDeletion of brain noradrenaline prevents electroconvulsive shock induced enhancement of 5-hydroxytryptamine and dopamine mediated behaviour. Nature 1980;285:232–233CrossRefGoogle Scholar
Hirose, , Shigehiro, , Ashby Charles, R Jr, Mills, , Mark, JJDEffectiveness of ECT Combined with Risperidone Against Aggression in Schizophrenia. J ECT 2001;17:22–6.CrossRefGoogle Scholar
James, DVGray, NSElective combined electroconvulsive and clozapine therapy. Int Clin Psychopharmacol 1999;14:69–72CrossRefGoogle ScholarPubMed
Janson, LHellsten, JTingström, ARegion Specific Hypothalamic Neuronal Activation and Endothelial Cell Proliferation in Response to Electroconvulsive Seizures. Biol Psychiatry 2006;60:874–881CrossRefGoogle Scholar
Kho, KHBlansjaar, BAde Vries, Set al.Electroconvulsive therapy for the treatment of clozapine nonresponders suffering from schizophrenia. Eur Arch Psychiatry Clin Neurosci 2004;254:372–379CrossRefGoogle ScholarPubMed
Konig, PGlatter-Gotz, UCombined electroconvulsive and neuroleptic therapy in schizophrenia refractory to neuroleptics. Schizophr Res 1990;3:351–354CrossRefGoogle ScholarPubMed
Kupchik, MSpivak, BMester, Ret al.Combined electroconvulsive-clozapine therapy. Clin Neuropharmacol 2000;23:14–16CrossRefGoogle ScholarPubMed
Modigh, KLong term effects of electroconvulsive shock therapy on synthesis, turnover and uptake of brain monoamines. Psychopharmacology 1976;49:179–185CrossRefGoogle ScholarPubMed
Oprea N, Nacu A, Revenco M. Psihiatrie. Chisinau, Editura Stiinta; 1994.Google Scholar
Petrides G, Mendelowitz A. Preliminary findings in ECT augmentation of clozapine in clozapine-resistant psychotic patients. Personal communication, September 2000.Google Scholar
Predescu V. Psihiatria, vol.1, Editura Medicală, Bucureşti; 1984.Google Scholar
Smith, SEActon, LSharp, TEnhancement of dopamine-mediated behaviour by the NMDA antagonists MK-801 and CPP: similarities with repeated electroconvulsive shock. Psychopharmacology 2004; 85–94Google Scholar
Snejnevski G. Îndrumar în Psihiatrie. Moscova, Medicina; 1985.Google Scholar
Tang, Wai Kwong, Ungvari, Gabor S. Efficacy of Electroconvulsive therapy combined with antipsychotic medication in treatment-resistant schizophrenia: A prospective, open trial. J ECT 2002;18:90–4.CrossRefGoogle Scholar
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